Raw Musings of a Psychotherapist Archives

On the therapist-client relationship, empathy, and the courage it takes to begin therapy

Part of the raw musings of a psychotherapist

When two people relate to each other authentically and humanly, God is the electricity that surges between them.
Martin Buber

I have been revisiting my thoughts on the relationship between therapist and client, and the importance of empathy during the first meeting.

It has been over 30 years now, but I remember the first time I went to therapy. Although I had no prejudice against going to a “shrink,” I still felt a bit funny. I guess the way I dealt with it was by convincing myself that I was not crazy, but only needed some help with certain specific issues. In fact, I prepared a list with the five items that, in my opinion, needed to be addressed.

I do not remember my therapist’s attitude in detail, but I do believe that she made me feel comfortable. She acknowledged my areas of concern, whether she agreed with them or not, I do not know, and also made me feel that my problems were solvable. Had she tried to go another way, for example, trying to convince me not to stick to a specific agenda, or letting me know that there might be other issues to consider, I might have felt like she was trying to sell me something I did not need and most probably would have said, “No thanks,” and walked away.

As therapists, we need to develop, from the first visit, a sincere appreciation for the client. We should acknowledge the client’s courage in being there: taking action, accepting that they need help, and trusting a perfect stranger with their deepest and darkest secrets and struggles. That is a lot! We would do well to provide some assurance that coming to therapy was the right move, that they are not crazy, and that there is hope.

The keyword is sincere. As humans, we can feel when someone is faking appreciation or support. In many ways, beneath such sincere support, authenticity and openness are required.

The other topic that keeps coming back, and that I relate to openness, is the need to remember that, even if the client comes to me looking for magical solutions or to be “fixed,” just as they might go to a priest, a guru, or a tarot reader, I should not receive them with a sense of superiority, but welcome them as an equal. As a fellow traveler on the path.

We therapists first have to clear our own trail (healer, heal thyself!), and then invite others to walk along with us, not as an example to be followed, but more like a traveling companion. Someone who, although they may have already visited this specific “country,” is a traveler nonetheless, still learning and discovering new things.

This means encouraging clients to try their own solutions, and walking together in the therapeutic relationship, where therapist and client meet, relate, and, through this meeting, healing occurs.

Yes, to be fully honest, I often find myself suspended in an inner tension. On the one hand, I notice my desire to present myself as wise, capable, insightful, and worth the money I am being paid. On the other hand, I hold the goal of meeting my client, and everyone, for that matter, as an equal, in an I-Thou way. Yes, we may be playing therapist-client roles right now, but underneath that, we are two human beings trying to figure out this thing called life the best way we can.

I remember attending a lecture a few years ago by Rabbi Michael Lerner, in which he discussed two different visions of the world. The first was the market-based society, where fear is the underlying feeling, and every time I meet someone, I evaluate how he or she may be of use to me. Basically, an I-It world. In such a world, it is clear that I, the evaluator, must assume myself to be better than the “its” to which I relate, the “its” I objectify.

The second was the love-based society, where the criteria for a relationship are love, mutual support, equality, and compassion. An I-Thou world. He seemed to suggest that most of the time we engage with each other in an I-It world, treating others as means to an end rather than acknowledging the miracle of having a living, thinking, feeling, unique human being in front of us.

It is as if, instead of appreciating something, a work of art, a sunset, a flower, a person, we are fixated on figuring out what we can get out of it.

It is sad.

May each of us keep remembering that every human encounter is a unique opportunity and a miracle. May you find, in your own therapy and in all your relationships, the joy of being seen and known, and of seeing the other as they are: radiant.

But then again, what do I know…

Therapy works best when you feel seen, respected, and met as a whole person. If this reflection resonates, we can explore whether working together feels like a good fit.

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Part of the raw musings of a psychotherapist

The Buddha proclaimed that there is no self. Buddhism encourages us to realize that our sense of who we are is an empty construction. There’s even a Ram Dass film called Becoming Nobody.

In contrast, the West wants us to become somebody. That is, to develop a cohesive, functional self, capable of setting boundaries, regulating affect, relating, and working well.

Today I want to focus on the Western side of this equation; on something I habitually see in therapy, though it is often hard to spot: the fear of not existing, which has nothing to do with the Buddhist no-self.

It sounds kind of weird, doesn’t it? Like something out of a fairy tale. Alice fearing that she might be nothing but some sort of figure in the Red King’s dream. But this is no fantasy.

Have you ever met someone constantly needing to be acknowledged or even admired? I’m sure you have. We may even be among them! Some find ways to get it through legitimate means. They find a platform that provides much-needed validation: performing, teaching, helping, creating… Others look for it, or even demand it, from those around them: parents, partners, children, co-workers, lovers…

I often meet them in therapy when their loved ones grow tired of having to prop them up, or, for the most successful among them, when they realize that all the fame, adulation, and acknowledgment are never enough to fill what feels like a hole within.

It is tempting to label them as narcissistic, and some may be, but when we dig deeper, we often find a deeply wounded and scared person facing an unbearable emptiness. A dread that, no matter how successful, funny, accomplished, or accommodating they are, they don’t matter. They feel unsubstantial, lacking matter. Nobody really cares. They could cease to exist, and nobody would even notice.

Although rarely articulated, they seem to fear that, if not noticed, they could dissolve like a dream upon awakening. To be clear, they don’t fear they would literally fade away; but a strange compulsion keeps them demanding attention because the alternative terrifies them.

How can this be?

Psychologically, we develop our sense of being real in relationship. Early on, we need to be seen, recognized, and responded to, not as stars, but simply as beings whose feelings, presence, and existence register in someone else’s mind. This is why young children yell things like, “Look, Mom, no hands!”

When that recognition (known as mirroring) is reliable enough, a person slowly develops an inner sense of solidity: I am here. I count. I remain myself even when no one is looking. But when that kind of acknowledgment is missing, inconsistent, or conditional, the person may continue to depend on outer confirmation to feel real. Then, being noticed starts to feel less like a satisfaction and more like a necessity.

That is why, for some, the hunger to be seen carries such desperation. What they are really fighting is not anonymity, but the old terror of feeling expendable, forgettable, irrelevant, as if they had no psychological weight. In milder forms, this manifests as shame, emptiness, or a chronic sense of not being important. In more serious forms, it feels like a threat to existence itself: If I do not register anywhere, if nobody notices me, do I even exist?

To put it simply, the fear of not mattering can devolve into something primal: the fear of not being, of becoming nothing in the eyes of others and, finally, in one’s own.

How can therapy help?

In a therapeutic relationship, a good-enough therapist offers a new kind of experience: one of being truly seen, perhaps for the first time. Over time, as the client is met by someone who notices them, takes them seriously, and does not reduce them to performance, usefulness, or image, they begin to internalize a steadier sense of being real.

They no longer need quite so much external proof to feel that they exist, count, and have weight. The therapist may also help them develop ways to self-validate, with affirmations such as: “I matter,” “Even when nobody is there, my existence matters,” or, if they are spiritually oriented, “I matter because God sees me, loves me, and cares about me.” ¹

It is interesting that, in psychedelic sessions, a recurrent insight is precisely how significant we are, how much we are loved, and how trivial our daily struggles can be. We learn that we are bigger, brighter, and more amazing than we can ever conceive.

Back to the Buddha.

So, should we build the self or see through its illusory nature? Do we matter, or are we empty? As often happens in therapy, the answer is both/and. Jack Engler famously said, “You have to become somebody before you can become nobody.”

Most Western psychotherapy focuses on helping people function in this material world. A healthy ego helps us remember where we parked the car, our Social Security number, and to pay our taxes. Eastern traditions aim toward liberation, toward becoming free from the limitations and illusions of this same world. Their goal is to go beyond the ego. But that’s a topic for a future article.

If you often feel like you need people’s acknowledgment, or if you have been accused of being too needy, insecure, or self-centered, you may have lacked the mirroring every single one of us needs. The good news is that this can be healed.

Remember that you matter and you are loved (and that you should not take yourself too seriously). If you are struggling, therapy can help you heal the fear of being inconsequential and free yourself from the harmful patterns that keep you from seeing who you really are.

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Tired of needing others to prove that you matter? If you often feel unseen, too needy, or dependent on others’ acknowledgment to feel real, therapy can help you build a steadier sense of self.
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However, it is worth noting that such affirmations alone won’t be enough if the wound from early childhood runs deep, as often happens in these cases. ↩︎

On the therapist-client relationship, empathy, and the courage it takes to begin therapy

Part of the raw musings of a psychotherapist

Part of the raw musings of a psychotherapist

How can this be?

How can therapy help?

Back to the Buddha.

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